Health Education Research Advance Access published online on May 20, 2004
Health Education Research, doi:10.1093/her/cyg073
© 2004 by Oxford University Press
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1 Centre for Sexual Health and HIV Research, University College London, London WC1E 6AU, UK
* To whom correspondence should be addressed. E-mail: rpower{at}gum.ucl.ac.uk.
Much attention has been placed on the need to develop and evaluate complex interventions targeting public health issues, such as reproductive health. However, and as has been the case in the recent past, even well-designed trials will be flawed unless meticulous attention is paid to ensuring the most appropriate intervention is designed and developed. This requires a well-resourced and carefully planned feasibility study, incorporating both formative and process evaluation, with particular attention being paid to the context of the proposed intervention. In this paper, we describe the way in which a feasibility study helped redesign and shape a complex intervention targeting adolescent sexual health in rural Zimbabwe. By using a mixture of in-depth interviews, focus groups and participant observation with pupils, parents, teachers and education officers, we were able to show that the intervention as originally conceived was unlikely to be deliverable. Process evaluation findings from the feasibility study led to substantial changes to both the content and delivery of the proposed intervention, which is now subject to testing for effectiveness in a large community randomized trial.
Accepted October 9, 2003
Original article
Developing complex interventions for rigorous evaluation-a case study from rural Zimbabwe
2 London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
3 Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe
4 Department of Psychology, University of Zimbabwe, Harare, Zimbabwe
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